Pathologist vs. B-Reader

Pathologists and B-Readers are both medical specialists whose expertise is essential in the diagnosis of asbestos-related diseases such as mesothelioma. Nevertheless, the purposes of the two physicians differ greatly, as well as their education and professional training. 

How Do Pathologists and B-Readers Evaluate Asbestos-Related Conditions?

While the expertise of both specialists can be extremely efficient in assessing the severity of mesothelioma and other conditions caused by asbestos exposure, the diagnostic methods employed by each of them are very different:

• A pathologist is specialized in diagnosing diseases, including asbestos-related forms of cancer such as mesothelioma, by conducting a careful examination of cells, bodily fluids and tissues. Thus, he focuses on the contents of a malignant tumor.
• The main task of a B-Reader, however, is to classify patients’ radiographs following a comparison with a standardized series of radiographic films. B-Readers analyze the appearance of the cancerous growth and its abnormalities.

What Are the Differences between the Analysis Conducted by a Pathologist and a B-Reader’s?

The evaluation procedures used by the two medical experts are significantly different:

• The tissue samples collected during a biopsy are sent to a laboratory for analysis, where the pathologist determines the amount and type of the cells. If the quantity of asbestos bodies exceeds the minimum number required in order to diagnose asbestosis or other similar disease, the pathologist can confirm the occurrence of the condition in question. Additionally, there are other criteria which guide the specialist in their analysis, such as the degree of fibrosis. Following an in-depth examination of the sample, a pathologist should be able to distinguish ferruginous bodies, which indicate the presence of asbestos from those formed on other types of minerals.
• Proficient in classifying radiographs of pneumoconioses (occupational lung diseases), B-Readers focus on the parenchymal opacities during their examination, which allows them to evaluate the severity of the disease. Thus, by comparing the patient’s set of radiographic films with a standardized series, a B-Reader will determine the type, size, location and profusion of the opacities, subsequently grading them from 0 (normal) to 3 (severe).

How Reliable Are the Results of the These Examinations?

The results of both types of examination are generally very accurate. However, due to the distinct procedures used in order to evaluate the severity of asbestos-related conditions, the report of a pathologist will differ greatly from that of a B-Reader:

• The pathologist’s report will offer a detailed and complex description of the cells’ particularities and the specialist will also assess a precise diagnosis.
• However, a B-Reader’s report will not state any concrete diagnosis, as their expertise allows them to only offer an opinion regarding the severity of the condition.

Due to their distinct areas of expertise, both the involvement of a pathologist and the specialized opinion of a B-Reader are essential in the process of diagnosing diseases and conditions caused by exposure to asbestos. By benefitting from multiple medical evaluations, each focused on very specific aspects, the final diagnosis will be more accurate and reliable, subsequently aiding oncologists in planning an effective treatment regimen for the patient.